Why Montgomery County ranks No. 1 in sexually transmitted disease

New cases of sexually transmitted diseases in the United States reached an all-time high in 2016. According to UPI, 1.6 million cases of chlamydia, 470,000 cases of gonorrhea and 28,000 of syphilis were reported that year.
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A new study diagnosing the nation's health puts Montgomery County among the healthiest places in Tennessee, but ranks it No. 1 in sexually transmitted disease.

Local health experts say that's one of the downfalls of being one of the youngest counties in the nation.

The findings are part of the Robert Wood Johnson Foundation annual health rankings. The study, a collaboration between the foundation and the University of Wisconsin Population Health Institute, each year releases an in-depth, state-by-state and county-by-county breakdown of health factors and life expectancy.

The state report focuses on key drivers of health, such as the number of children living in poverty. In Tennessee, the results show Montgomery County ranks ninth among Tennessee's 95 counties in health outcomes and 14th in health factors.

Health outcomes measure how long people live and how they feel. Health factors measure the things that influence the health outcome, such as behaviors like alcohol consumption, tobacco use and exercise; access to care; social and economic factors including education, employment and income; social support; and the physical environment, including air and water quality, housing and transportation.

The category in which Clarksville stood out — sexually transmitted infection — measures the number of newly diagnosed chlamydia cases per 100,000 people. Montgomery County's rate is 871.8. The overall statewide rate much lower, at 477.5, and the national rate is 479.

Joey Smith, director of the Montgomery County Health Department, closely monitors the report, and said the occurrence of reported STDs is largely age-driven.

Montgomery County’s population is the youngest of any county in Tennessee, and it’s one of the 50 youngest counties in the nation. The median age in Montgomery County is 30.3, while statewide it's 38.7 and nationwide it's 37.8.

“We have disease intervention specialists who reach out to those persons who’ve been diagnosed with an STD, to try to find out who their most recent sexual partners were, so that we can try and prevent its further spread,” Smith said.

Focused prevention efforts are under way at Fort Campbell, Austin Peay State University and in the Clarksville-Montgomery County School System, he said.

In the category of STDs, the health report only specifies occurrences of chlamydia.

“This is a form of STD that is more acute and treatable, and it’s easier to capture statistically. Other forms, such as HIV, don’t always give us a clear picture, because, for example, you might have someone in your community who tests HIV-positive, but they may not have contracted that HIV in your community,” Smith said.

The data is collected from the most recent years available, in this case from 2015. STD rates for Montgomery County have been far above the state and national averages since at least 2007, the first year available in the report. They spiked in 2012 at 980 and have remained above 850 since then.

Montgomery County's HIV rate was lower than the state average, with 172 cases per 100,000, where the statewide rate is 297.

Smith said Montgomery County is making strides toward improving its leading causes of illness and death. Those three categories are tobacco use, physical activity or the lack of it, and obesity.

“Last year just in reductions of tobacco use alone, we added a combined 43,000 years of life expectancy. We still have plenty of work to do, but that is a huge achievement,” Smith said.

In smoking, 21 percent of Montgomery County residents are smokers, while 22 percent of Tennesseans smoke.

In adult obesity, Montgomery is at 31 percent, and the state is at 32 percent.

For several other areas, Montgomery ranked as healthier than the state, such as in premature death, high school graduation, violent crime and injury deaths.

Most and least healthy

The healthiest county in Tennessee is Williamson County. The county ranks first among Tennessee counties in both health outcomes and health factors.

The complete list of Tennessee county rankings show Williamson, Wilson, Rutherford, Sumner and Moore as the five healthiest counties. The bottom five, starting with the least healthy, are Grundy, Meigs, Lake, Cocke and Campbell.

"This year's rankings are a call to action to see how these persistent health gaps play out locally, take an honest look at their root causes and work together to give everyone a fair shot at a healthier life," said Julie Willems Van Dijk, director of County Health Rankings & Roadmaps, in a news release.

Jimmy Settle and the Memphis Commercial Appeal contributed to this report. Reach Chris Smith at chrissmith@theleafchronicle.com, 931-245-0282 or on Twitter @cssmithwrites.